| NPI | 1386332492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL THOMPSON Ar/ Billing Account Manager 307-231-5472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2023-05-05 |